Friends of New Troy

"building a community one neighbor at a time"
Please fill in the requested information, then print this page (and sign it if using credit card) and mail it along with your donation.  Please do not submit credit card information by e-mail as we are not secured to receive.  Thank you.


Membership/Pledge Form


Name: E-mail:

Billing address: Phone:

Billing City, State, Zip:

I (we) pledge a total of $ to be paid (check one):

now monthly quarterly yearly

I (we) plan to make this contribution in the form of (check one): 

cash check credit card other

Credit card type:

Authorized signature:

Credit card number:

Expiration date:

Please use the following name(s) in all acknowledgements:

Check here if you wish your gift to remain anonymous:

Check here if you wish us to notify you by e-mail when new issues of New Troy Moving On are posted online:

Make checks payable to Friends of New Troy, and mail to:

Friends of New Troy
P.O. Box 125
New Troy, MI 49119